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  2. CQM-6662

CMS02 - Use 30 day recurring encounters with different qualifying encounters within the 30-day encounter..

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      Thank you for your inquiry on CMS2: Preventive Care and Screening: Screening for Depression and Follow-Up Plan. Patients have to be screened for depression on the date of the encounter or up to 14 days prior to the date of the encounter to be eligible for the numerator. For the encounter on 12/1/23, the depression screening (performed on 12/20/23) would not qualify because it occurred after the encounter (12/1/23). On the other hand, if there was another encounter on 12/31/23, then the depression screening on 12/20/23 would qualify for that encounter (i.e., 12/31/23) because the depression screening occurred up to 14 days prior to the date of the encounter.
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      Thank you for your inquiry on CMS2: Preventive Care and Screening: Screening for Depression and Follow-Up Plan. Patients have to be screened for depression on the date of the encounter or up to 14 days prior to the date of the encounter to be eligible for the numerator. For the encounter on 12/1/23, the depression screening (performed on 12/20/23) would not qualify because it occurred after the encounter (12/1/23). On the other hand, if there was another encounter on 12/31/23, then the depression screening on 12/20/23 would qualify for that encounter (i.e., 12/31/23) because the depression screening occurred up to 14 days prior to the date of the encounter.
    • CMS0002v12
    • Large impact on reporting incorrect outcomes related to using only the date of the start of a 30-day recurring encounter as the qualifying date, not the date of when the actual qualifying encounter is completed within that 30-day recurring encounter.

      We have a Cancer TIN that we report on that uses 30-day recurring encounters (ex.12/1-12/31) with use of multiple qualifying encounter codes by different providers within this 30-day encounter. While validating the measure CMS02(Screening for Depression and Follow-Up Plan) we have come across a patient that had a depression screening on in the middle of the 30-day encounter, (ex. use of 30-day recurring encounter of dates 12/1/23-12/31/23 with qualifying encounter code of 99205 on 12/20/23 with proper depression screening completed on 12/20/23), our vendor is saying because the encounter started on 12/1/23 and screening was done on 12/20/23 that is after the start date and would not be used to determine the patient outcome on the report. We see it as there was not a qualifying encounter code (99205) used on the start of this 30-day recurring encounter of date of 12/1/23, the date was within this 30-day recurring encounter on 12/20/23 of a qualifying encounter performed with visit code and depression screening performed on the date of 12/20/23.  Per our vendor they have to use the date of the start of the 30-day recurring encounter related to the specification logic, see below. Can you clarify if this is how the logic is intended to be used when there is a 30-day recurring encounter involved? Thank you.

      Per Specification " (AdultScreening.relevantDatetime, AdultScreening.relevantPeriod ) 14 days or less on or before day of start of QualifyingEncounter.relevantPeriod

            edave Mathematica EC eCQM Team
            Tallred Tara Allred
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